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How Mindfulness Changes Your Brain

Discussion in 'Psychiatry' started by Mahmoud Abudeif, Sep 29, 2020.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    Mindfulness, even when inadvertent, can have powerful effects on your brain. I know because it happened to me. Let me tell you the story.

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    A while back, I was having breakfast in the backyard, reading the “newspaper” on my laptop. (Actually, there was no paper and very little real news.) I was simultaneously listening to music on my favorite classical music station, KDFC out of San Francisco.

    They were playing some sweet piano music (a nocturne by Chopin). It was so enchantingly beautiful that I closed my eyes, savoring it. And, then something strange happened.

    At one with the music

    It can’t be fully described in words, except to say that I felt “one with the music.” All of my attention was focused on it, on every note, every nuance in the almost imperceptible changes in tempo and loudness.

    I had known and loved this piece for many years, but it was that morning, at that very moment that I discovered the tonality of it—the way Chopin arranged the composition around a central note.

    What was going on in my brain? I realized that I was unintentionally practicing mindfulness. To some, the very word evokes a smirking dismissal of “new age” psychobabble. I know because I have done it myself.

    But that sublime encounter with Chopin profoundly affected me and led me to delve more deeply into the notion of mindfulness.

    What is mindfulness?

    Simply put, being mindful means being acutely aware of, without reacting emotionally, what is happening now. This is instead of the usual state-of-mind where your thoughts drift into the past or you muse about the future, Mindfulness is the opposite of a wandering mind.

    When I listened to that piece of music, I enjoyed it more than I ever had before. I was acutely aware of every note. But at the same time, I discovered the tonality, or the mechanics, of creating the music. This gave me the intellectual satisfaction of discovery but none of the emotional uplift of the music, itself.

    Of course, this episode hardly matters in the grand scheme of things. If this is all there is, enjoying music on a deeper level, than it’s really not worth taking the time to read this post. But my Chopin moment is only a metaphor for a much bigger phenomenon. So read on.

    Anxiety and PTSD

    What’s the difference between fear and anxiety? Fear is generally elicited by particular cues or contexts. My dog becomes fearful at the sound of thunder. In the context of the African savannah, the image of a leopard is fear-provoking, but in the zoo or on TV, it is just a handsome, powerful cat.

    Anxiety, on the other hand, can occur in the absence of triggers. In its chronic form, it can be quite debilitating. How debilitating? PTSD is an extreme example.

    Stressful experiences can precipitate acute episodes of PTSD in vulnerable people. The momentary stress we all experience when we hear a car backfire close by can trigger an anxiety attack of devastating proportions in a veteran of the Iraq war.

    The natural reaction to attacks of anxiety is to try and avoid them. This can take the form of alcohol and drugs, or cognitively “taking your mind off it.” Both responses are ineffective and tend to accomplish exactly the opposite—that is increasing, instead of decreasing the anxiety.

    How does mindfulness work in anxiety and PTSD?

    Mindfulness employs a Jiu-Jitsu approach. Rather than trying to avoid or numb the unpleasant feelings, being mindful means acknowledging the cues that precipitate the response while remaining completely detached. People are taught to do the following:

    • Pay attention to the cues and your reaction to them
    • Become aware of the “mechanics” of your physical and emotional response
    • Observe how these triggers provoke your attacks as if you are watching it in a movie.
    This is because when you observe and analyze something “clinically”, you rob it of its emotional punch.

    Does it work?

    Let’s take a look at some studies:

    Melissa A. Polusny, Ph.D, of the Minneapolis Veterans Affairs Health Care System, and her colleagues randomly assigned 116 veterans with PTSD to treatment for their disorder.

    Half of the group (58 individuals) were assigned to receive nine sessions (8 weekly 2.5-hour group sessions and a daylong retreat) of mindfulness-based stress reduction therapy (MBSR). These sessions focused on teaching patients to pay attention to the present moment in a “non-judgmental, accepting manner.”

    The other half received something called present-centered group therapy (PCGT) consisting of nine weekly group sessions focused on current life problems. Outcomes were assessed before, during, and after treatment and at 2-month follow-up. Here are the results:
    • Participants in the MBSR group demonstrated a greater improvement in self-reported PTSD symptom severity after treatment and at the 2-month follow-up compared to the PCGT group (48.9% vs 28.1%)
    • However, there was no difference in rates of loss of PTSD diagnosis at post-treatment (42% vs 44%) or at 2-month follow-up (53% vs 47%).
    The results are certainly modest. The main problem is the relatively short duration of the improvement. So it remains to be seen if a more prolonged practice of MBSR would result in a commensurate prolonged effect.

    But the study does demonstrate that stress reduction through the practice of mindfulness definitely works.

    How mindfulness changes your brain?

    A lot of research on the neurobiology of meditation and its offshoot, mindfulness, has been done. Unfortunately, the vast majority of it is of poor quality.

    Despite that, the anatomy of brain regions that participate in mindful meditation is coming into light through the use of fMRI.

    Britta Holzel and her co-investigators, in a study published in the journal Psychiatry Research: Neuroimaging, measured the gray matter density of the hippocampus. This is an area of the brain that is known to store and regulate memories. It also plays a role in the regulation of emotions.

    The researchers found significant increases in the density of the left hippocampus. This study confirmed that structural changes in this region are detectable within 8 weeks following the participation in mindfulness training program. Other areas of interest in the brain that served as controls had no such changes in gray matter density.

    Other areas of the brain that are changed

    The investigators then went a step further. Rather than stop with the pre-selected “areas of interest”, they looked at the whole brain. And, that was quite illuminating. Here is what they found in various brain regions:
    • The insula
    Exploratory analysis of the entire brain revealed four clusters with significantly greater gray matter concentration post-training compared with the pre-training time-point in the MBSR group. One cluster was located in the posterior cingulate cortex where an area called the insula is located.

    The insula is known to be impacted in interoceptive/visceral (basically, what’s going on in your body) awareness as well as in empathic responses (your ability to know what’s going on physically and emotionally in the other person). More generally, it plays an important role in human awareness or consciousness.
    • Temporoparietal junction
    One cluster was located in the left temporoparietal junction (TPJ). It has been suggested that the TPJ is a crucial structure for the conscious experience of the self, mediating spatial unity of self and body.

    Impaired processing at the TPJ may lead to the pathological experience of the self, such as disembodiment or out-of-body experiences. Furthermore, the TPJ is also involved in social cognition (a.k.a. social intelligence), i.e., the ability to infer states such as desires, intentions, and goals of other people.
    • The cerebellum and brain stem
    The researchers also identified two clusters in the cerebellum and brain stem. These areas of the brain are associated with the more primitive functions of the brain, such as maintenance of fine movement and balance. So what does it have to do with emotional well-being?

    Some scientists suggest that in the same way that the cerebellum regulates the rate, force, rhythm, and accuracy of movements, it also regulates the speed, capacity, consistency, and appropriateness of cognitive and emotional processes. In other words, it modulates behavior automatically around a homeostatic baseline.

    Given the importance that the regulation of emotions and cognition play in healthy psychological functioning, the morphological changes in these regions might contribute to the positive effects of mindfulness meditation on the salutary changes in well-being.

    Indeed, more recent studies corroborate the initial findings of imaging studies on the neuronal and molecular levels. An excellent summary of these studies can be found in the ” Handbook of Mindfulness: Theory, Research, and Practice.*[​IMG]

    The bottom line

    It is becoming obvious now that mindfulness is not mere psychobabble gobbledygook. It has a solid neuronal basis and there is increasing evidence of its salutary effect on emotional health and behavior.

    So go ahead, and practice some mindful meditation. Ten minutes a day will do you good.

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